Report calls for “proportionate” response to future crises as many vaccines left unused

Responding to the 2009 swine flu pandemic cost the State over €70 million in anti-virals, vaccines and specialist equipment, according to a new Department of Health report.

Far more doses of vaccine were delivered than were actually distributed, the report shows; of 3 million doses delivered to Ireland, only 1.75 million were distributed to GPs, hospitals and health centres.

The report says the overall response to the pandemic was satisfactory, but it makes a number of recommendations for future emergencies.

The National Pandemic Influenza Plan should be revised to ensure a “proportionate” response to meet the differing demands of pandemic influenza viruses of milder and more severe impact rather than just focusing on “worst case” planning assumptions.

Exercises should be held regularly to test the plan to identify potential gaps in response and these should be co-ordinated from the National Emergency Co-ordination Committee, it says.

Co-ordination critical
According to the report, co-ordination and co-operation between Government departments, agencies and private enterprise is critical to pandemic preparedness and it is important for all groups to have clear roles and responsibilities in order to avoid duplication of roles.

The 2009-10 swine flu (H1N1) pandemic mostly affected children and young adults, with 80 per cent of cases affecting people under 35 . More than 1,000 people were admitted to hospital with the virus, 100 of them to intensive care.

There were 29 deaths, all but two from at-risk groups; most victims had significant underlying medical conditions.

As the pandemic developed, the recommendations for vaccine dosage changed as more scientific evidence became available. This meant that most people required only one, not two doses, of pandemic vaccine.

While 1.75 million doses were distributed, only 1.1 million vaccinations were recorded, giving an uptake of 25 per cent of the total population.

Before the pandemic began, planning was based on scenarios derived from previous influenza pandemics in 1918, 1957 and 1968, which killed millions of Europeans. The HSE had contracts in place for the provision of almost 8 million doses of pandemic vaccine, but fewer than half of these were ultimately delivered.

Milder pandemic
The pandemic turned out to be milder than anticipated in terms of numbers falling ill, hospitalisations and deaths. As a result, the pressure on the health service was significantly less than anticipated.

The report is particularly critical of the significant difficulties experienced by the authorities in accessing accurate and timely information about airline contacts. There were delays in acquiring passenger lists from airlines and a failure to obtain up-to-date and complete information about travellers’ whereabouts.